The K24 award will enable Dr. Eisner to build and expand his mentoring program in patient oriented research (POR) and to include a greater number and diversity of trainees. Moreover, the K24 will provide the opportunity to take on two key leadership roles in mentoring at UCSF: (1) to become Associate Director of the NHLBI-funded T32 Multidisciplinary Training Program in Lung Disease at UCSF (T32HL007185-31) and Director of the Pulmonary Clinical Research Scholars (PCRS) Training Program. The PCRS Training Program, which is one of the two core components of the T32, was developed 15 years ago to provide training in POR focused on lung disease. This director role will provide Dr. Eisner with a unique opportunity to develop his leadership and mentoring skills on a programmatic level;(2) to become Chair of the UCSF Clinical and Translational Science Institute Mentor Development Program's Junior Faculty Mentoring Program. This will enable him to develop a systematic program for teaching junior faculty how to be effective scientific research mentors to their trainees. The K24 award will enable Dr. Eisner to expand his POR program in new and novel directions. Specifically, he will expand the focus of the NHLBI-funded FLOW (Function, Living, Outcomes, and Work) study, which is a prospective cohort study of 1,202 persons with COPD, to elucidate the effects of the social and physical environment on the risk of functional limitations and disability in COPD. In particular, the proposed study will determine the impact of the social environment, which is the connections a person has with the larger social community, on the disablement process in COPD. It will also evaluate the impact ofthe physical environment, including both indoor air quality and outdoor air pollution, on the risk of disability and adverse health outcomes in COPD. The K24 will add (1) Area level measures of social and physical environment using a geocoding approach and (2) Home visits to assess the indoor physical environment and neighborhood environment. Importantly, the K24 will add a substantive environmental research focus to Dr. Eisner's POR program on COPD. RELEVANCE (See instructions): Disability from COPD is substantial, and will markedly increase during the next two decades. Because current medical treatments have minimal impact on disease progression, a strategy to prevent COPD-related disability will have important clinical and public health benefits. Elucidating the effects of environmental exposures on the risk of disability in COPD will provide a basis for screening and prevention of disability. (End of Abstract)